1. Field of the Invention
The present invention relates generally to devices for detecting the occurrence of enuresis, and more particularly to devices for conditioning a child to avoid enuresis as by providing an aversive stimulus.
2. Description of the Prior Art
Apparatus for the treatment of enuresis are known, an early example appearing in an article by O. H. Mowrer entitled, "Apparatus for the Study and Treatment of Enuresis," appearing in the American Journal of Psychology, vol. 51, pp. 163-66 (1938) (hereinafter cited as Mowrer I).
The apparatus described in Mowrer I, as well as many similar devices today known and used, have as their intended function the awakening of a child "immediately upon the commencement of urination" (Mowrer I at 163). It is theorized that by providing the alarm stimulus upon urination, the alarm will condition the child to avoid bed wetting as by contraction of the sphincter whenever the child's bladder distends, thereby avoiding further urination.
Significantly, it is believed by some persons knowledgable in the field that complete awakening of the child upon each and every instance of bed wetting is necessary to develop the desired conditioning. This belief is reflected in Mowrer I wherein the author stresses the importance of such awakening. For example, Mowrer suggests that an attendant awake the child while the bell is ringing should the child not awaken thereby, and also notes a specially constructed bed which partially drops to awaken the child if the bell alone is insufficient (Mowrer I at 164).
Mowrer, in a later article entitled "Enuresis--A Method for its Study and Treatment, " appearing in The American Journal of Ortho Psychiatry, vol. 8, at pp. 436-59 (1938) (hereinafter cited as Mowrer II), reiterates the requirement of an awakening stimulus to condition the child towards sphincter contraction upon bladder distention (Mowrer II at 445).
S. H. Lovibond, in an article entitled The Mechanism of Conditioning Treatment of Enuresis, appearing in Behavior Research and Therapy, vol. 1, pp. 17-21 (England 1963) (hereinafter cited as Lovibond), describes what he refers to as a "twin signal instrument" in which an aversive stimulus lasting for less than one second is sounded upon moistening of a detecting pad by a bed wetting child. After the stimulus sounds, a silent interval of one minute follows and then a low audible buzzer operates continuously for the purpose of summoning an attendant (Lovibond at 20). Contrary to the opinions of Mowrer, Lovibond hypothesizes that complete awakening of the child by the device is not necessary and designs his instrument accordingly. However, an attendant is required at all times to reset the instrument and change the detecting pad in response to the continually sounding, low audible buzzer thereby awakening the child. Thus, the Lovibond instrument provides only a short duration aversive alarm in the hopes that complete cessation of enuresis by the child will thereby be promoted, regardless of the amount of urine discharged by him at any one time.
It will be understood that both the Mowrer and Lovibond conditioning programs have certain attendant disadvantages and inconveniences. For example, using training techniques such as suggested by Mowrer and Lovibond, the child and all those nearby are awakened upon or soon after each instance of bed wetting, regardless of the amount.
Notably, training a child to avoid enuresis using either of the above apparatus does not provide a "reward" for the child by which the child can be taught to avoid a continuous aversive alarm by timely sphincter contraction. Neither the Mowrer nor Lovibond devices provides any change in the functioning of their respective apparatus with regard to any improvement in the child's enuretic behavior. Thus, contingent reinforcement of increased sphincter control is not possible with either device until complete control is achieved. As already stated, the aversive stimulus in the Lovibond instrument operates to sound for a time of less than one second from the very beginning of the training period to the very end. The Mowrer alarm similarly responds uniformly throughout the training period. Thus, both devices negate the possibility of any contingent reward type of training.
Another prior art device appears in U.S. Pat. No. 2,907,841, issued Oct. 6, 1959, which shows an enuresis signaling device wherein both a light and bell are activated in response to bed wetting. The bell alarm is manually disconnected by the bed wetter while the light remains on until the patented device is reset by an attendant. The device does not, however, suggest an alarm signal different from that taught by Mowrer whereby the bed wetting child is caused to be awakened and, once awake, must disconnect the alarm.